Experience in the use of multimodal analgesia in victims of road accidents with combined chest and abdominal injuries in the prehospital and hospital periods

Objective. Тo evaluate the possibility of using analgesics, dalargin and correctors of tissue metabolism in multimodal analgesia in victims of road accidents with  combined  chest  and  abdominal trauma.

Tasks: To study the combined effect of multimodal analgesia with the inclusion of dalargin, ketorolac or lornoxicam and a corrector of metabolic disorders on clinical and biochemical parameters, changes in gas composition, acid-base blood state and neuro-humoral condition in victims of road accidents with combined chest and abdominal trauma in the acute period of traumatic illness. 2. To propose standard schemes of multimodal anesthesia that can be applied to groups of victims with combined chest and abdominal trauma of varying severity during evacuation from the scene of a traffic accident by emergency medical personnel.

Materials and methods. A study was conducted in 107 patients with diagnoses of road trauma, combined chest and abdominal trauma. In order to objectify the severity of the patients› condition, the Glasgow com, RAS scales and the method developed by us for assessing the severity of victims with combined trauma were used.

The results of the study. Traumatic shock in victims of road accidents with combined chest and abdominal trauma leads to impaired consciousness, microcirculation, hypoxia, hypotension, while adaptation of the main body functions developed in an irrational way — due to tachycardia. This, in our opinion, is dangerous, as evidenced by the signs of ischemia on the ECG. The combined use of analgesics, dalargin and a tissue metabolism.

Conclusion. The use of multimodal anesthesia in the prehospital period of emergency medical care made it possible to significantly reduce the patient›s hospital stay by 4.8 bed days and reduce the overall mortality rate in severely injured patients from 72.7% in the comparison group to 51.7% in the main group.

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